Thieffry C, Chenin L, Foulon P, Havet E, Peltier J
Department of Organogenesis and Anatomy, Universite de Picardie Jules Verne, 3 rue des Louvels, 80036, Amiens, France.
Surg Radiol Anat. 2017 Jul;39(7):773-778. doi: 10.1007/s00276-016-1800-0. Epub 2016 Dec 30.
The neurotomy of musculocutaneous nerve is a treatment for patients who suffer from spastic elbow flexion when medical and reeducative treatments have failed. It consists in sectioning motor branches of musculocutaneous nerve which are destined to the biceps brachii and brachialis muscles, both being the main elbow flexor muscles. The aim of this study was to analyse the distance, where each motor branch arises from the musculocutaneous nerve to both biceps brachii and brachialis muscles, to establish precisely the localisation and length of the necessary incision to reach its branches for surgery.
Eighteen musculocutaneous nerves from ten cadavers were dissected. None of them reported with a previous pathology. The cadavers were laid on the back with 30-35° of abduction, a complete extension, and supination of the upper limb.
The localization of motor branches was to be found in the middle third of the upper arm, with an average from the base of the humeral major tubercle of 11.46, 12.40, and 12.87 cm for the biceps brachii and 16.36, 19.10, and 16.88 cm for the brachialis muscle.
The incision needed to reach the motor branches of the musculocutaneous nerve should be localised between 10 and 20 cm from the major humeral tubercle and may be shorter than usual.
对于经药物治疗和康复治疗无效的肘部痉挛性屈曲患者，肌皮神经切断术是一种治疗方法。该手术包括切断肌皮神经的运动分支，这些分支支配肱二头肌和肱肌，这两块肌肉均为主要的肘部屈肌。本研究的目的是分析每个运动分支从肌皮神经发出至肱二头肌和肱肌的距离，以精确确定到达其分支进行手术所需切口的位置和长度。
解剖了来自10具尸体的18条肌皮神经。这些尸体均无既往病理情况。尸体仰卧，上肢外展30 - 35°、完全伸直并旋后。
运动分支位于上臂中1/3处，从肱骨大结节基部起，至肱二头肌的平均距离分别为11.46、12.40和12.87厘米，至肱肌的平均距离分别为16.36、19.10和16.88厘米。
到达肌皮神经运动分支所需的切口应定位在距肱骨大结节10至20厘米之间，且可能比通常情况短。
